Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 PDF

CERTIFIED PROFESSIONAL IN ACCESSIBILITY CORE COMPETENCIES Body of Knowledge October 2023 United in Accessibility www.accessibilityassociation.org Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict This page intentionally left blank. Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict IAAP 2023 CPACC Body of Knowledge Development Volunteer Contributors: Cindee Calton, CPACC Nathan Clark. CPACC Sean Durkin, CPACC Collette Fransolet, CPABE Level Three Jill Hart, CPACC, PMP Cooper Hollmaier, CPACC Maria Matheas, CPACC Lacy Skrzeczkoski, CPACC Charlotte van Oostrum, CPACC Editors: Péter Kemény, CPACC, ADS Sara Kjellstrand, CPACC Program Manager: Susanna Laurin, CPACC IAAP Staﬀ Liaison: Samantha Evans, CAE, ICE-CCP Editorial Notes: British and American English o The citations and resources are gathered from international sources. o IAAP does not change the presentation of British English and/or American English. o You will find both presentations in this document. Person-First vs. Identity-First o G3ict follows UN CRPD guidance and person-first language. o Other organizations and advocacy groups may use identity-first language. o IAAP does not change the presentation of disability language from the source. o You will find both person-first and identity-first language in this document. Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Edits and changes to the 2023 CPACC Body of Knowledge Once each quarter update requests will be reviewed for links, formatting, etc. Changes will be listed to identify changes and time frame for edits/versioning. February 2024: V2.2 Page numbering corrections Page 13: Added CART or STTR to captioning Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict This page intentionally left blank. Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict IAAP CPACC Body of Knowledge Table of Contents 1. The Purpose of this Document............................................................................................................. 1 2. IAAP CPACC Exam Preparation Resources............................................................................................. 1 3. About the CPACC Professional Certification.......................................................................................... 2 4. The CPACC Certification Content Outline Concepts At-A-Glance.......................................................... 2 5. Additional CPACC Resources and Other IAAP Information................................................................... 3 CPACC Content Outline:................................................................................................................................ 4 Domain One: Disabilities, Challenges, and Assistive Technologies (40%)..................................................... 4 Domain One A: Characterize and Differentiate Between Theoretical Models of Disability, including the strengths and weaknesses of their underlying assumptions.................................................................... 4 1. Medical Model............................................................................................................................. 4 2. Social Model................................................................................................................................ 5 3. Biopsychosocial Model................................................................................................................ 6 4. Economic Model.......................................................................................................................... 6 5. Functional Solutions Model......................................................................................................... 7 6. Social Identity or Cultural Affiliation Model................................................................................ 7 7, Charity Model.................................................................................................................................... 7 Domain One B: Categories and Characteristics of Disabilities, Associated Barriers, and Solutions......... 9 Domain One C: Identify Appropriate Assistive Technologies and Adaptive Strategies at the Level of the Individual for Permanent, Temporary and Episodic Disabilities (ICT and Physical World)........................ 9 1. Visual Disabilities....................................................................................................................... 10 2. Auditory Disabilities................................................................................................................... 12 3. Deaf-Blindness........................................................................................................................... 14 4. Speech and Language Disabilities.............................................................................................. 15 5. Mobility, Flexibility, and Body Structure Disabilities.................................................................. 18 6. Cognitive Disabilities.................................................................................................................. 20 7. Seizure Disabilities..................................................................................................................... 27 8. Psychological Disabilities........................................................................................................... 28 9. Multiple/Complex Disabilities................................................................................................... 31 Domain One D: Demonstrate an Understanding of the Data Trends and Implications of Disability Demographics and Statistics................................................................................................................... 33 Domain One E: Apply Disability Etiquette into Practice.......................................................................... 35 Domain Two: Accessibility and Universal Design (40%).............................................................................. 36 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Domain Two A: Distinguish Between Individualized Accommodations (Solutions Designed Only for Exceptional Individuals, to Make Up for Shortcomings in the Main Design) and Universal Design (Items or Environments Designed to be Used by a Wide Range of Individuals with Diverse Abilities)............. 36 Domain Two B: Identify Benefits of Accessibility.................................................................................... 38 Domain Two C: Identify and Apply Accessibility Principles (from WCAG 2.1) of Web Accessibility....... 39 Domain Two D: Identify and Apply Accessibility Principles for the Built Environment.......................... 41 Domain Two E: Identify and Apply Principles of Universal Design......................................................... 42 Domain Two F: Identify and Apply Principles of Universal Design for Learning (UDL)........................... 44 Define the Concept of Universal Design for Learning (UDL)............................................................... 44 Define the Concept of Usability and User Experience (UX)................................................................ 45 Domain Three: Standards, Laws, and Management Strategies (20%)........................................................ 48 Domain Three A: Identify and Characterize International Declarations and Conventions on Disability Rights....................................................................................................................................................... 48 1. The Universal Declaration of Human Rights.............................................................................. 49 2. Convention on the Rights of Persons with Disabilities (CRPD).................................................. 49 3. The Marrakesh Treaty................................................................................................................ 50 Domain Three B: Identify and Characterize Regional Instruments on Human and Disability Rights...... 52 1. EU Charter of Fundamental Rights............................................................................................ 52 2. The African Charter on Human and People’s Rights.................................................................. 53 3. The Inter-American Convention on the Elimination of All Forms of Discrimination Against Persons with Disabilities..................................................................................................................... 54 Domain Three C: Identify and Characterize National and Provincial Instruments on Human and Disability Rights....................................................................................................................................... 55 1. The Equality Act 2010................................................................................................................ 56 2. The Americans with Disabilities Act of 1990............................................................................. 57 3. Ontarians with Disabilities Act of 2001..................................................................................... 57 4. Disability Laws in EU countries.................................................................................................. 58 Domain Three D: Identify and Characterize Domain-Specific and Government Procurement Laws and Regulations.............................................................................................................................................. 59 Domain Three D: Domain Specific Laws.............................................................................................. 59 Domain Three D: Procurement Laws.................................................................................................. 60 Domain Three E: Applying Accessibility Standards and Regulations to ICT............................................ 61 Domain Three F: Integrating ICT Accessibility Across the Organization................................................. 64 1. Resources:.................................................................................................................................. 64 2. W3C Web Accessibility Initiative Recommendations................................................................ 64 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict 3. European Agency for Special Needs & Inclusive Education Guidelines..................................... 65 4. Maturity Models........................................................................................................................ 66 5. The Importance of Management Champions............................................................................ 68 6. Evaluating for Accessibility........................................................................................................ 68 7. Recruiting and Hiring................................................................................................................. 69 8. Communication Management Strategies.................................................................................. 70 9. Legal & Public Relations Implications........................................................................................ 70 10. Purchasing Processes and Public Procurement..................................................................... 70 Additional Reading.................................................................................................................................. 71 Domain One: Disabilities, Challenges, and Assistive Technologies..................................................... 71 Domain Two: Accessibility and Universal Design................................................................................ 72 Domain Three: Standards, Laws, and Management Strategies.......................................................... 72 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict IAAP CPACC Body of Knowledge Introduction 1. The Purpose of this Document This Body of Knowledge contains the knowledge and skills expected to obtain the Certified Professional in Accessibility Core Competencies (CPACC) credential. The four main purposes of this document are to: List the categories of information covered in the exam Present general information about each domain topic Recommend study topics related to each job task Provide links to resources on each topic Provide additional reading resources for expanded study The Body of Knowledge is an open resource designed as a starting point when studying for the CPACC exam. This CPACC Body of Knowledge presents concepts, theories, and other information that candidates should master to indicate possession of core competencies expected of accessibility professionals. The Body of Knowledge is designed to help candidates prepare for the IAAP CPACC Certification exam and provides references for additional learning and exploration. This Body of Knowledge does not provide an exhaustive explanation of every concept or question on the exam; its use does not guarantee exam success. Please also explore the Additional Reading Section at the end of this document. The web is a dynamic place, we cannot guarantee that all links will continue to work. If you find any broken links, please alert us at [email protected] 2. IAAP CPACC Exam Preparation Resources This CPACC Body of Knowledge and the CPACC Certification Content Outline should be the base of every CPACC study preparation plan to identify new or less familiar topics. CPACC candidates are welcome to prepare for the exam by studying high quality materials available from reputable sources. IAAP lists free and for-purchase CPACC preparation resources on our About CPACC webpage in the Prepare for the CPACC Exam section. IAAP maintains a list of IAAP Approved CPACC Certification Preparation Providers on this same webpage. Use of any preparation course does not guarantee exam success. 1 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict 3. About the CPACC Professional Certification The Certified Professional in Accessibility Core Competencies (CPACC) credential is IAAP’s foundational professional certification. It represents the practical application of broad, cross-disciplinary conceptual knowledge of: 1. disabilities 2. accessibility and universal design, and 3. accessibility-related standards, laws, and management strategies. Relevant domains for the CPACC credential include: The web and other information communication technologies (ICT) Architecture and the built environment Consumers and industrial design Transportation systems, and Any domain in which thoughtful design, policy, and management can improve disability access. The CPACC is the baseline IAAP professional certification for both non-technical and technical accessibility roles. For those in technical roles, IAAP also offers the Web Accessibility Specialist (WAS) and the Accessible Document Specialist (ADS) certifications. Individuals who pass both the CPACC and WAS exams carry a higher-level credential called the Certified Professional in Web Accessibility (CPWA). 4. The CPACC Certification Content Outline Concepts At-A-Glance Domain One: Disabilities, Challenges and Assistive Technologies (40% of the exam) o Theoretical Models of Disability o Categories of Disabilities and Associated Barriers (ICT and Physical World) o Assistive Technologies and Adaptive Strategies o Disability Demographics and Statistics o Disability Etiquette Domain Two: Accessibility and Universal Design (40% of the exam) o Individual Accommodations versus Universal Design o Benefits of Accessibility o Accessibility in Information Communication Technology (WCAG 2.1) o Accessibility in the Physical World (The Principles of Universal Design 2.0) o Universal Design for Learning Guidelines (UDL) o Accessibility, Usability, and User Experience (UX) Domain Three: Standards, Laws, and Management Strategies (20% of the exam) o International Conventions and Treaties on Disability Rights o Categories of Disability Laws and Regulations o Applying Accessibility Standards and Regulations to ICT o Organizational Governance and Management 2 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict 5. Additional CPACC Resources and Other IAAP Information IAAP home page IAAP Certification Overview CPACC Certification Content Outline CPACC Frequently Asked Questions CPACC Preparation Resources IAAP-Approved Certification Preparation Providers IAAP Certification Exams FAQ Continuing Accessibility Education Credits (CAEC) and Renewal FAQ Process of creating a professional certification IAAP Certification Exams: Copyright and Intellectual Property IAAP Overlay Position and Recommendations 3 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict CPACC Content Outline: Domain One: Disabilities, Challenges, and Assistive Technologies (40%) Domain One A: Characterize and Differentiate Between Theoretical Models of Disability, including the strengths and weaknesses of their underlying assumptions. Recommended Study Tasks Identify prominent theoretical models of disability. Describe their basic concepts and understand their strengths and weaknesses. Identify which models align most closely with the principles of accessibility and universal design. Apply the models to example scenarios in the lives of people with disabilities. Overview Theoretical models of disability provide perspectives and frameworks to understand disability. No model is comprehensive so can be neither fully correct nor incorrect. Each has strengths and limitations. In practice, organizations generally use aspects of multiple models, particularly the social and medical models. 1. Medical Model Definitions From Disabled World: “The medical model is presented as viewing disability as a problem of the person, directly caused by disease, trauma, or other health condition which therefore requires sustained medical care provided in the form of individual treatment by professionals. In the medical model, management of the disability is aimed at a ‘cure,’ or the individual’s adjustment and behavioral change that would lead to an ‘almost-cure’ or effective cure. In the medical model, medical care is viewed as the main issue, and at the political level, the principal response is that of modifying or reforming health care policy.” From Disability Australia Hub: “The medical model of disability sees disability as a ‘problem’ that belongs to the individual. It isn’t seen as an issue for others, just the person who is affected. For example, if a student using a wheelchair is unable to get into a building because of some steps, the medical model would suggest that this is because of the person’s physical disability, rather than the steps.” Strengths The medical model can address the biological sources of disabilities, either by clinically curing them or providing ways to medically manage conditions. The medical component of disabilities is a critical reality for many people. Weaknesses The medical model treats disability as a problem or inherent characteristic of the individual. It seeks a cure or medical management of a bodily condition. The medical model often overlooks issues caused by unwelcoming or inaccessible environments or “broader sociopolitical constraints including attitudes, policies and (lack of) regulations.” 4 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict From the US National Institutes of Health: “One result of the common medical understanding of disability is that people with disabilities often report feeling excluded, undervalued, pressured to fit a questionable norm, and / or treated as if they were globally incapacitated. People with disabilities often express frustration when they are met with pitying attitudes or incredulity if they speak about anything positive related to living with their conditions.” 2. Social Model Definitions From Disability Hub Australia: “The social model of disability says that the way society is conceptualised causes disability, rather than a person’s impairment or difference. It looks at ways of removing barriers that restrict life choices for people with disabilities. When barriers are removed, people with disability can be independent and equal in society, with choice and control over their own lives.” From Disabled World: “The social model of disability sees the issue of ‘disability’ as a socially created problem and a matter of the full integration of individuals into society. In this model, disability is not an attribute of an individual, but rather a complex collection of conditions, many of which are created by the social environment. Hence, the management of the problem requires social action and is the collective responsibility of society at large to make the environmental modifications necessary for the full participation of people with disabilities in all areas of social life. The issue is both cultural and ideological, requiring individual, community, and large-scale social change. From this perspective, equal access for someone with an impairment / disability is a human rights issue of major concern.” From the UK Ombudsman: “According to the social model a person does not ‘have’ a disability – disability is something a person experiences. The disability experienced is often caused by the approach taken by society/individuals which fails to take account of people with impairments and their associated needs. This can result in people with impairments being excluded from mainstream society. For example, an individual is not prevented from reading a magazine because of blindness, but because of the absence of alternative formats. A person is not prevented from going to see a play because they are a wheelchair user rather it is the absence of accessible transport and access to venues that causes the disability and exclusion. The social model of disability also focuses on people’s attitudes towards disability and recognises that attitudes towards disability can present barriers for disabled people in the same way the physical environment can. These attitudes are many and varied, ranging from prejudice and stereotyping to unnecessary inflexible organisational practices and procedures and seeing disabled people as objects of pity / charity.” Strengths The social model’s focus on the disabling conditions in society and the environment emphasizes that barriers and challenges experienced by people with disabilities are not inevitable, nor exclusively a characteristic of an individual’s “broken” body. Societies can improve the lives of people with disabilities considerably by ensuring the world is designed to accommodate a wide range of human characteristics and abilities. Weaknesses The social model of disability can downplay the embodied aspects of disabilities, as if disability has nothing to do with bodily characteristics at all. The social model’s push for social justice in the political 5 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict arena can also put activists at odds with people with other political interests, antagonizing relationships and sometimes creating resolute political adversaries. 3. Biopsychosocial Model Definitions From Physio-Pedia: “The Biopsychosocial Model of disability is an attempt to account for both the social and biomedical models of disability. First conceptualized by George Engel in 1977, it suggests that to understand a person’s medical condition it is not simply the biological factors that need to be considered, but also the psychological and social factors: Bio (physiological pathology) Psycho (thoughts, emotions, and behaviours such as psychological distress, fear/avoidance beliefs, current coping methods and attribution) Social (socio-economical, socio-environmental, and cultural factors such as work issues, family circumstances and benefits/economics)” In 2002, the World Health Organization published the International Classification of Functioning, Disability and Health (ICF). The ICF describes the complex phenomenon of disability and integrates the social and medical models. It is derived from the biopsychosocial model of disability. Strengths The biopsychosocial model can be used in situations related to rehabilitation. Within the medical model, doctors traditionally focus on medical cures and areas of pathology and impairment. This medical approach stands in contrast to the participation-based approach of health and social care professionals. In the biopsychosocial model, a rehabilitation team would integrate both aspects to develop a support intervention that accounts for both a person’s medical and social situation. Weaknesses There are fears that the combination of health aspects with the social model in the World Health Organisation International Classification of Functioning, Disability and Health (ICF) would lead to a definition of disability as only being the result of societal factors, thus downplaying the medical needs of people with disabilities. The classification is also complex, which could lead to difficulties in implementation. 4. Economic Model Definition From Disabled World: “The economic model of disability defines disability by a person’s inability to participate in work. It also assesses the degree to which impairment affects an individual’s productivity and the economic consequences for the individual, employer, and the state. Such consequences include loss of earnings for and payment for assistance by the individual; lower profit margins for the employer; and state welfare payments. This model is directly related to the charity model.” The economic model is used by policymakers in the context of determining and assessing disability benefits. Strengths The economic model recognizes the effect of bodily limitations on a person’s ability to work, and that may require economic support and / or accommodations for the person’s disability. 6 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Weaknesses The economic model creates a legally defined category of people who are needy, which can be stigmatizing. Additionally, if a person doesn’t meet the legal “disabled” threshold, or if there is a dispute about a person’s disability, the person with the disability may not receive the support they need. 5. Functional Solutions Model Definition From Handwiki: “The functional solutions model of disability is a practical perspective that identifies the limitations (or “functional impairments”) due to disability, with the intent to create and promote solutions to overcome those limitations. The primary task is to eliminate, or at least reduce, the impact of the functional limitations of the body through technological or methodological innovation.” The work of accessibility professionals can be viewed through the lens of this model. Strengths This model is results oriented. It seeks to solve real-world challenges, attends to the needs of people in their own circumstances and is based on providing services. Weaknesses Profit-driven technology entrepreneurs can sometimes miss the mark, creating products that may be innovative but neither practical nor useful. Some products may be of more benefit to the innovators than to the target population, especially if they are expensive. A narrow focus on technology may lead to miscalculations or missed opportunities in cases where social, political and environmental aspects ought to be considered to fix an issue effectively. 6. Social Identity or Cultural Affiliation Model Definition The social identity or cultural affiliation model refers to a sense of deriving one’s personal identity from membership within a group of like-minded individuals. This model is most evident among people who are deaf. Deaf culture and identity owe much of its strengths to the somewhat exclusive nature of being a part of a close-knit linguistic minority. Other people with disabilities may also feel a sense of belonging to a community with common life experiences. Strengths The social identity or cultural affiliation model accepts the person’s disability completely and uses it as a point of pride in associating with other people in a similar condition. Weaknesses The sense of belonging felt within a group of people can be counterbalanced by feelings of exclusion for people who don’t fit the group’s expectations. 7, Charity Model Definition The charity model regards people with disabilities as unfortunate and in need of outside help. People providing charity are viewed as benevolent contributors to a needy population. It is related to the medical model, treating disability as an individual problem, and to the economic model in that it views disability in terms of the economic consequences to the individual. 7 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Strengths The charity model can inspire people to contribute their time and / or resources to provide help when it is genuinely needed. Weaknesses The charity model can be condescending toward people with disabilities. They may resent feeling like they are an object of pity, and that they must depend on accepting or cultivating this pity. The charity model often focuses on short-term, immediate needs at the expense of more comprehensive and ultimately more effective long-term solutions. Resources Disabled World: Disabilities: Definition, Types and Models of Disability UK Ombudsman: Introduction to the Social and Medical Models of Disability (PDF) Youth Disability Advocacy Services: Four models of disability Association of University Centers on Disabilities, Disability in Public Health: Compare and Contrast Different Models of Disability Disability Australia Hub: Disability models in the Disability A-Z Handwiki: The Functional Solutions Model: Disability studies Physio-pedia: Conceptual Models of Disability and functioning American Psychological Association, Psychological Bulletin: The Social Identity Approach to Disability: Bridging Disability Studies and Psychological Science (PDF) John Lawson. International Studies in Sociology of Education: Disability as a Cultural Identity (PDF) Lane, Harlan. Journal of Deaf Studies and Deaf Education: Ethnicity, Ethics, and the Deaf-World 8 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Domain One B: Categories and Characteristics of Disabilities, Associated Barriers, and Solutions; and Domain One C: Identify Appropriate Assistive Technologies and Adaptive Strategies at the Level of the Individual for Permanent, Temporary and Episodic Disabilities (ICT and Physical World) You will find both Domain One B and One C information grouped together with each disability. Recommended Study Tasks Name the main categories of disabilities. Classify specific conditions under the appropriate disability category or categories. Describe the accessibility challenges faced by people with disabilities of a given category. Understand the concepts of assistive technologies, adaptive strategies, and accessibility solutions. Identify and provide examples of accessibility, potential solutions, and assistive technologies for different types of disabilities. Understand that potential solutions and assistive technologies are designed for or relevant to information communication technology (ICT) or the physical world. Overview There are many types of disabilities that affect people’s abilities to see, hear, speak, move, think, and feel. This section lists categories and types of disabilities and discusses the barriers people with disabilities often face to full participation in society. There is also information about accessibility, potential solutions, and assistive technologies. Assistive technologies are products, devices, systems, or items used by people with disabilities to perform tasks which they could not do otherwise. Assistive technologies are also called adaptive technologies or adaptive software when used with computers. Some assistive technologies rely on the output of other “user agents” such as graphical desktop browsers, text browsers, voice browsers, multimedia players, and plug-ins. Not all assistive technologies are computer-based. For example, communication boards made of cardboard are a type of assistive technology. In some contexts, assistive technologies refer exclusively to products, devices or systems provided to people with disabilities via a social security system. In other contexts, a wider definition includes products, tools and systems that are available to anyone for free or to buy. Adaptive strategies are tweaks and adjustments that people with disabilities use to perform daily living activities. These strategies increase their independence and ability to participate in society. Adaptive strategies enhance or change ways of interacting with the environment or technology to accomplish a task. Adaptive strategies can involve software such as settings to personalize the presentation of a document or website. An example of an environmental adaptive strategy is to move closer to a person speaking in an auditorium to hear better. Accessibility is about designing products, services, and environments to ensure equal access for everybody including people with disabilities. Accessibility measures can be applied to the physical environment (such as building access), technology, the transport sector, and other public and private 9 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict services. The provider, producer or owner of the product, service or environment is responsible for providing accessibility measures. 1. Visual Disabilities Overview Visual disabilities are sensory disabilities that include: some amount of vision loss loss of visual acuity (sharpness) increased or decreased sensitivity to specific or bright colors complete or uncorrectable loss of vision in either or both eyes. Blindness Definition: Blindness is a sensory disability involving some vision loss, nearly complete vision loss, and complete vision loss. Characteristics: Some people are completely blind, so cannot see anything. Others can perceive light versus dark or general shapes of large objects but cannot read text or recognize people by sight. Demographics: From the World Health Organization Fact Sheet: Vision Impairment and Blindness: Globally, at least 2.2 billion people have vision impairment or blindness. Of these, at least 1 billion have a vision impairment that could have been prevented or has yet to be addressed. Globally, the leading causes of vision impairment are uncorrected refractive errors and cataracts. Most people with vision impairment are over 50 years old. Color Vision Deficiency Definition: Color vision deficiency is a sensory disability where a person may not be able to distinguish certain color combinations. Characteristics: The most common form of color vision deficiency affects a person’s ability to distinguish reds and greens. Other colors may also be affected. Demographics: According to the US National Institutes of Health, US National Library of Medicine: Red-green color vision defects are the most common form of color vision deficiency. This condition affects 1 in 12 males (8.3%) and 1 in 200 females (0.5%). Blue-yellow color vision defects affect males and females equally. This condition occurs in fewer than 1 in 10,000 people worldwide. Low Vision Definition: The American Federation for the Blind offers a functional definition: Low vision is uncorrectable vision loss that interferes with daily activities. It is better defined in terms of function, rather than numerical test results. In other words, low vision is “not enough vision to do whatever it is you need to do,” which can vary from person to person. Most eye care professionals prefer to use the term “low vision” to describe permanently reduced vision that cannot be corrected with regular glasses, contact lenses, medicine, or surgery. 10 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Characteristics: A person with low vision will typically need magnification to read or discern other details. Some people with low vision experience low contrast so benefit from high contrast text and graphics. Some experience color deficiencies, which means they may not be able to see the difference between certain colors. Demographics: According to the World Health Organization, about 246 million people, or 3.5% of the world’s population, have low vision. About 90% of people with vision impairments live in low-income settings. Barriers for People with Visual Disabilities From the W3C’s Web Accessibility Initiative, World Blind Union, and other sources: Materials, such as books, restaurant menus, and navigation aids are not available in alternate formats such as digital files or braille People who do not adequately describe navigation steps or visual information Inadequate lighting Sounds masking informative sounds like directional cues Non-tactile signs Objects in travel paths that become obstacles In websites and other technologies: images, controls, and other meaningful elements that do not have text alternatives Text, images, and page layouts that cannot be resized or lose information when resized Missing visual and non-visual orientation cues, page structure, and other navigational aids Video content that does not have text or audio alternatives, or an audio description track Inconsistent, unpredictable, or overly complicated navigation mechanisms and page functions Text and images with insufficient color contrast between foreground and background Websites, web browsers, and authoring tools that do not enable users to set up custom color combinations Websites, web browsers, and authoring tools that do not work fully when using a keyboard Solutions for People with Visual Disabilities Accessibility – Physical Environment: Use raised tiles on the ground to indicate the edge of a platform, a pathway along a sidewalk, the beginning of a staircase, etc. Eliminate low-hanging architectural features that a blind person could bump into. Clear obstructions in hallways and on sidewalks. Information in Braille on signs and controls (e.g. elevator buttons, code locks) Tactile controls on flat devices such as microwaves and dishwashers Accessibility – ICT Environment: Provide text alternatives for non-text information. Make sure graphical design allows for magnification. Use color combinations with high contrast. Do not rely on color alone to convey meaning or information. Standard, consistent positioning and visual presentation of objects 11 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Assistive Technologies: Screen readers convert the text and structural information of interfaces and content to speech. Audio description is an additional audio track that describes and gives context for essential visual information. Screen magnification Large print GPS-based navigation instructions with an audio interface, either automated or via a remote human navigator Mobile apps that provide audio descriptions of photographed objects or people Mobile apps that scan barcodes or QR codes and speak product information aloud Software to customize color contrast, color filters, and color themes Canes help people feel their surroundings as they walk. Service animals help people navigate. Resources on Visual Disabilities World Health Organization, Fact Sheet: Blindness and Vision Impairment World Blind Union, External resource paper: Universal design (.doc) American Federation for the Blind: Low Vision and Legal Blindness Terms and Descriptions US National Institutes of Health, US National Library of Medicine, Color Vision Deficiency Royal National Institute of Blind People (RNIB): Assistive technology Vision Australia: Top 10 pieces of assistive technology for newly diagnosed patients American Foundation for the Blind (AFB): Technology Resources for People with Vision Loss University of Illinois Library: Blind/Visual Impairment: Common Assistive Technologies Mobility International USA: Assistive Technology for Blind or Low Vision Participants 2. Auditory Disabilities Overview Auditory disabilities are sensory disabilities that range from partial to complete hearing loss. Deafness Definition: Deafness is the total or near total loss of hearing. Characteristics: A person who is deaf or hard of hearing has difficulty with sounds, including the audio part of multimedia. The first language of people who are born deaf is often sign language. They may feel less comfortable reading text because it is a second language, and the phonetic notation does not help their understanding. By contrast, those who lose their hearing later in life may never learn sign language. If they do learn it, they may not feel as comfortable speaking in sign, and may prefer text. Hard of Hearing Definition: Hard of hearing (HOH) refers to people with hearing loss ranging from mild to severe who still have some useful hearing. People who are hard of hearing may communicate through sign language and/or spoken language, with or without amplification. Most HOH people can use the phone and use hearing aids. 12 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Characteristics: Individuals who are hard of hearing have partially impaired hearing in one or both ears resulting in a mild-to-moderate hearing loss. There may be enough hearing ability that a device like a hearing aid or FM system provides enough help to process speech. Demographics: According to the World Health Organization, an estimated 430 million people have disabling hearing loss. According to the European Commission Knowledge Centre on Interpretation, 750,000 persons in the European Union use sign language as their first language. Central Auditory Processing Disorder Definition: According to the American Speech-Language-Hearing Association (ASHA): Auditory processing disorder (APD) is often described as greater than expected difficulty hearing and understanding speech even though no measurable hearing loss exists. People with auditory processing disorders may act like they have hearing loss despite normal hearing sensitivity. APD is often confused with other disorders such as attention deficit hyperactivity disorder (ADHD), language impairment, learning disabilities, social and emotional delays, or cognitive deficits. APD is not an inability to hear. Rather, it’s an inability to interpret, organize, or analyze what’s heard. The hearing pathway works well but parts of the brain do not. Characteristics: People with Central Auditory Processing Disorder can have difficulty with locating the source of a sound, understanding what was said in loud environments, following spoken directions, learning songs or instruments, paying attention, responding promptly, or learning a new language. Behaviors can vary depending on the person and the presence of other disorders. Demographics: It is estimated that approximately 5% of the global population have Central Auditory Processing Disorder. Barriers for People with Auditory Disabilities From the W3C’s Web Accessibility Initiative and other sources: People who speak softly or in large spaces without aids such as microphones Absence of sign language interpretation Loud environments or competing sounds such as background noise Conversations, interactions, and meetings where accessing communication from multiple speakers is challenging Poor lighting conditions that prevent lip-reading Websites and other technologies that require voice interaction or listening to engage with content Audio in videos and films presented without captions or transcripts Media players that do not support captions, or do not contain options to control the volume, or customize the size and color of captions Solutions for People with Auditory Disabilities Accessibility Sign language interpretation CART or STTR accurate & usable captions for videos, live online meetings, live presentations Text alternatives such as transcripts for audio content 13 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict For doorbells, alarms and other alerts: Provide alternative visual alerts, such as lights that flash, pulse, dim, or turn on and off Quiet work environments or the option to work in different settings Clear signage for meeting rooms with microphones connected to audio induction loops Environments designed with good acoustics and lighting Assistive Technologies Assistive listening systems and devices in meeting rooms and auditoria Personal listening devices (PLD) to connect with assistive listening systems Hearing aids Cochlear implants Audio controls Haptic alerts / feedback Visual labels / notifications / alerts Text-to-speech (TTS) software Sound field systems to amplify voices of speakers (e.g. teachers in a classroom) Noise-canceling headphones Resources on Auditory Disabilities World Health Organization: Health Topics: Deafness and Hearing Loss American Speech-Language-Hearing Association: What is Hearing Loss? European Commission Knowledge Center on Interpretation: Sign language interpretation WebAIM: Auditory Disabilities Hearing Australia: Everything You Need to Know about Hearing American Speech-Language-Hearing Association: Central Auditory Processing Disorder Understood: Assistive Technology for Auditory Processing Disorder 3. Deaf-Blindness Overview Deaf-Blindness is a rare condition that uses touch as the primary means of communication. Definition: Deaf-Blindness is a sensory disability that includes both deafness and blindness. Most people who are Deaf-Blind are not completely deaf nor completely blind and retain some hearing and sight capability. Characteristics: A person who is both deaf and blind experiences the characteristics of those two disabilities with the added complexity of meaningful sensory input being limited to touch, smell, and taste. Of those senses, touch is the only viable means of complex communication. A Deaf-Blind person learns braille to access text and sign language to access conversation, with the Deaf-Blind person feeling the signing hands of the other person in the conversation. Demographics: The incidence of Deaf-Blindness is low. According to the World Federation of the Deaf- blind, between 0.2% and 2% of the world’s population is Deaf-Blind. Barriers for People with Deaf-Blindness For materials such as books, menus and navigation aids, lack of printed braille For websites and other technologies, incorrect or incomplete output to a braille keyboard Lack of braille transcripts of video or audio materials Lack of tactile sign language interpretation 14 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Solutions for People with Deaf-Blindness Accessibility Transcripts of video or audio materials made available in braille Tactile sign language interpretation Other solutions based on the individual needs Assistive Technologies Screen reader converting text to braille on a refreshable braille device For audio and video: conversion of transcripts to braille Printed braille Haptic alerts / feedback Cane Service animals Tactile navigation aids Tactile sign language interpretation Deaf-Blind communicator Resources on Deaf-Blindness National Center on Deaf-Blindness: Overview on Deaf-Blindness Deafblind International: What is Deaf-Blindness? Project IDEAL: Deaf-Blindness Deafblind Information Australia: Living with Deafblindness National Center on Deaf-Blindness Library: Assistive Technology Perkins School for the Blind: Communication Technology for Persons Who Are Deafblind National Federation for the Blind: Deaf-Blind Communication Technology American Foundation for the Blind: Unique Technologies Presented at First Deaf-Blind International Conference, June 2018 4. Speech and Language Disabilities Overview Speech and language conditions are related and often grouped together but there are differences. Using language is about being able to understand, formulate and share ideas through words. Language disorders may affect not only speech but also the ability to write, read and understand information. Speech disorders specifically concern the way people say words and make sounds. Speech sound disorders Speech sound disorders is an umbrella term for difficulties ranging from mild slurred speech to a complete inability to move the mouth to speak. The ability to physically speak may be completely unrelated to the person’s language capabilities; they may be able to read, write, and understand language even if their mouth structure or neuromuscular connections prevent them from speaking. Speech disorders may be caused by or a side-effect of underlying disabilities, either present at birth or acquired. A person’s speech may improve, remain stable, or worsen over time. Organic speech sound disorders Definition: According to the American Speech-Language-Hearing Association, organic speech sound disorders include disorders resulting from motor/neurological disorders, including: 15 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Apraxia of speech: when the person knows what they want to say but the brain has difficulty planning the movements involved in speaking Dysarthria: difficulty controlling the muscles used to speak Structural deficiencies: cleft lip palate Sensory/perceptual disorders e.g. hearing loss Characteristics: These vary by the type of speech sound disorder as well as between individuals. According to the National Institute of Deafness and Other Communication Disorders and others, some characteristics include: Slurred or slow speech Making inconsistent speech errors Distorting sounds Errors in tone, stress or rhythm. Functional speech sound disorders Definition: According to the American Speech-Language-Hearing Association, functional speech sound disorders do not stem from acquired or developmental disorders and have no known cause. Characteristics: Functional speech sound disorders typically include errors in articulation (clear and distinct sounds) and phonology (sound patterns). Demographics: According to the ASHA, speech sound disorders statistics vary greatly due to inconsistencies in classifications and variations in the studied age groups. Prevalence is higher among children (5 to 25% depending on age group) than adults (1-2%). No Speech Definition: Having no speech, or mutism, is an inability to speak. It can be caused by damage to the brain and / or speech muscles, by emotional or psychological reasons, or by a combination of causes. Characteristics: Neurogenic mutism is caused by brain injury. It is often the outcome of extreme forms of other organic speech or language disorders, including aphasia, apraxia, or dysarthria. Psychogenic mutism is where speech loss has psychological rather than neurological causes. There are three types of psychogenic mutism: Elective mutism, where a person chooses not to speak Selective mutism, where a person wants to speak but cannot do so in certain situations due to anxiety Total mutism, in which a person does not speak at all Demographics: Selective mutism is estimated to affect 0.47% to 0.76% of the population. Statistics on the incidence of neurogenic mutism are not available. Aphasia Definition: Aphasia is a language disorder resulting from neurological damage. It affects all use of language, not just speech. According to the National Aphasia Association, “Aphasia is an impairment of language, affecting the production or comprehension of speech and the ability to read or write. Aphasia is always due to injury to the brain-most commonly from a stroke, particularly in older individuals. But brain injuries resulting in aphasia may also arise from head trauma, from brain tumors, or from infections.” 16 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Characteristics: There are multiple types of aphasia. A person with aphasia may not recognize words or understand what is being said, be unable to speak or have difficulty saying what they mean, difficulty forming sentences and omitting words. Demographics: Statistics from the National Aphasia Association state that: There are at least 2,000,000 people in the USA with aphasia There are at least 250,000 people in Great Britain with aphasia The global incidence rate is currently unknown. Barriers for People with Language and Speech Disabilities Complex communication systems Not enough time to communicate, access information or respond Lack of understanding and patience by persons when communicating, such as in different service-based contexts Lack of alternatives for speech communication, such as multimodal or text-based alternatives. Solutions for People with Language and Speech Disabilities Accessibility Simplified communication methods, including multiple options for communication Increased understanding, patience and adaptations by persons when communicating Additional time to complete tasks Providing the option to use text-based alternatives to speech to communicate Assistive Technologies Producing speech: Text-to-speech programs or Augmentative and Alternative Communication (AAC) devices. Processing language: Screen readers can read interfaces and content and convert digital text to synthesized speech. Users can adjust the speech rate, voice and pitch to get varied exposure to content when they repeat it. Keyboards with speech generating functionalities Electronic communication boards with symbols or images Voice carryover Programs with writing templates, organizational tools, word prediction and spell checkers. Speech-to-text programs. Speech apps to allow learners to practice their sounds, sentences, and phrases Resources on Speech and Language Disabilities American Speech-Language-Hearing Association (ASHA): Speech Sound Disorders- Articulation and Phonology American Speech-Language-Hearing Association (ASHA): Speech and Language Disorders US National Institutes of Health, National Institute on Deafness and Other Communication Disorders: Apraxia of Speech National Aphasia Association: Aphasia Definitions Illinois University Library: Speech Disorders: Common Assistive Technologies 17 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict 5. Mobility, Flexibility, and Body Structure Disabilities Overview Mobility impairment includes: people with upper or lower limb loss or disability challenges with manual dexterity disability in co-ordination with different organs of the body a broken skeletal structure. Physical and mobility impairments limit independent, purposeful physical movement of the body or of one or more limbs. Impact to a person’s mobility may be temporary or permanent. Mobility disabilities can be present at birth, acquired with age, or be the result of disease. Manual Dexterity/Fine Motor Control Definition: Fine motor skills are intricate hand and wrist movements needed to manipulate, control, and use objects, produce neat, legible handwriting, and dress independently. Fine motor skills involve coordinated efforts of the brain and muscles and are built on gross motor skills involved in making bigger movements. Disability may be temporary, recurring, or permanent. Characteristics: Examples include: difficulty tying shoelaces inability to do up buttons or zippers scribbly drawing difficulty using a keyboard poor handwriting taking a long time to pick up small objects, manipulating objects in hand, or using both hands at the same time. Demographics: Direct statistics are unavailable. Persons who may have issues with fine motor control include older adults, people with Autism or ADHD, and persons with ataxia (the loss of fine motor skills resulting from neurological damage or disorder e.g. stroke, cerebral palsy, or Multiple Sclerosis). Ambulation Definition: The Nursing Outcomes Classification defines ambulation as the ability to walk from place to place independently with or without an assistive device. Characteristics: A person’s ability to walk may be impacted by congenital conditions, disease, or injury, such as cerebral palsy, neuromuscular disorders, amputation, arthritis, and back injuries. Demographics: There are no specific statistics on ambulation disabilities. According to the US Centers for Disease Control, 11 percent of adults in the US have mobility disabilities. Similar figures have been reported for countries in Europe and Canada. Muscle Fatigue Definition: According to the US National Institutes of Health: Muscle fatigue is a common non-specific symptom experienced by many people and is associated with many health conditions. It is often defined as an overwhelming sense of tiredness, lack of energy and feeling of exhaustion, and it relates to a difficulty in performing voluntary tasks. 18 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Characteristics: According to Healthline.com: Muscle fatigue can occur anywhere on the body. An initial sign of this condition is muscle weakness. Other symptoms associated with muscle fatigue include soreness, localized pain, shortness of breath, muscle twitching, trembling, a weak grip, muscle cramps. Demographics: There are no specific estimates of people affected by muscle fatigue as it can be caused by a variety of factors, such as illness, age, medication and treatment side effects, inactivity, and depression. Body Size or Shape Definition: Body size or shape disabilities are disabilities caused by disorders that affect a person’s stature, proportions or shape. Examples include acromegaly, dwarfism, rheumatoid arthritis, and obesity. Characteristics: Characteristics depend on the specific disability. Orthopedic conditions such as arthritis and joint mobility are frequently associated with the underlying cause. Other examples of co-occurring conditions include muscle weakness and fatigue, hearing loss, vision loss, cardiopulmonary disorders, and diabetes. Demographics: There are no specific estimates of numbers of body size or shape disabilities as definitions and causes of disabilities vary. Barriers for People with Mobility, Flexibility, and Body Structure Disabilities Physical Environment Seating that is too small, or at the wrong height. Appliances and controls that are out of reach or require touch instead of voice commands. Narrow walkways, doorways, passages, or aisles Tasks that require fine motor skills, like small or round door handles Tasks that require accuracy, like small buttons, switches, or dials Tasks that require strength, like heavy doors High shelves or high counters Tables without knee and toe clearance Products and equipment that require a standing position or are difficult to reach or manipulate such as automatic teller machines (ATMs), health care or workplace equipment that is not accessible. Steps, thresholds, and other obstacles to gaining entry to a space. Body shaming and social discrimination. Digital Environment: Digital interfaces that require interaction via a specific interface such as keyboard or mouse Digital interfaces with small and / or tightly grouped touch targets that are hard to hit accurately Solutions for People with Mobility, Flexibility, and Body Structure Disabilities Accessibility Universally designed entrances to buildings (level access, wide entrances) Clearly defined, wide and unobstructed paths of travel Ensuring that clickable areas on a website/app are big enough to hit Not placing interactive elements on a website/app too close to each other 19 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Ensuring that objects in the physical environment provides enough space and size for reach and use regardless of the user’s body size, posture or mobility Assistive Technologies in the Physical Environment Walkers, canes, crutches Manual and electric wheelchairs, motorized scooters Stair lifts, elevators Exoskeletons Stepladders Grab / rail / handlebars Reachers Touch or voice operated light fixtures Assistive Technologies in ICT Switch devices replacing keyboards or mouses (e.g. sip and puff devices) Adaptive or customizable keyboards Voice control Eye tracking Speech-to-text software Head wand Oversized mouse or trackball Adjustable position displays Resources on Mobility, Flexibility, and Body Structure Disabilities WebAIM: Motor Disabilities Case Western Reserve University: Mobility/Dexterity Impairments (PDF) US National Institutes of Health: Muscle Fatigue: General Understanding and Treatment Healthline.com: What Causes Muscle Fatigue? Mayo Clinic: Acromegaly Mayo Clinic: Dwarfism WebAIM: Motor Disabilities Assistive Technologies 6. Cognitive Disabilities Overview Cognitive processes are the ways a person takes in and interprets information. In these processes, we use mental functions. Examples of mental functions involved in cognitive processes are: Attention functions Memory functions Psychomotor functions Emotional functions Perceptual functions Thought functions Calculation functions 20 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Cognitive disabilities can affect one or more mental functions by varying degrees. Cognitive processes can be affected by both internal and external factors. Internal factors are impairments in one or more mental functions. External factors include issues such as information overload, stress, or sleep deprivation. Studies show stress has a highly disruptive impact on working memory for people with and without cognitive impairments. A person’s ability to take in and understand information in a certain situation is therefore dependent on both the person’s capacity and the broader context. Cognitive disabilities may occur on their own or result from conditions or injuries such as traumatic brain injury. They may also co-occur with other types of disabilities. Note that the degree of mental functioning varies largely between people; two people with the same diagnosis may not share the same experiences. A cognitive diagnosis is based on multiple criteria and people diagnosed with a cognitive disability do not necessarily fulfill all criteria of that diagnosis. Adaptive strategies and assistive technology for people with cognitive disabilities are not specifically developed for a certain diagnosis but to support a specific mental function. In this section, the barriers and adaptive strategies are grouped by mental functions rather than diagnoses. Intellectual Disabilities Definition: Intellectual disability is characterized by significant limitations in intellectual functioning (reasoning, learning, problem solving) and in adaptive behavior, which covers a range of everyday social and practical skills. Definitions vary depending on the country. What some countries call intellectual disabilities are called learning disabilities elsewhere. The Diagnostic and Statistical Manual of Mental Disorders 5th Revision (DSM-V) published by the American Psychiatric Association uses the term intellectual disability. There are three main criteria for diagnosing intellectual disability in the DSM-V: 1. The person has deficits in intellectual functions. Typically, a person with intellectual disability has an IQ below 70-75. 2. The person has impairments in adaptive behaviour. These include skills needed to independently manage daily tasks and include social skills, communication skills, and skills needed to manage school or work. 3. The impairments manifest during the developmental years (in childhood). If similar conditions appeared after a head trauma in adulthood, the diagnoses would be different. Characteristics: In daily life, persons with intellectual disabilities face challenges in one or more areas of adaptive behavior. According to the American Association on Intellectual and Developmental Disabilities, adaptive behavior includes the collection of conceptual, social and practical skills needed in everyday life: 1. Conceptual skills include language, reading, writing, managing time, managing numbers, reasoning, knowledge, memory 2. Social skills include interpersonal skills, social judgment and responsibility, communication skills, the ability to follow rules and the ability to make and keep friendships 21 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict 3. Practical skills include the ability to perform tasks independently such as personal care, job responsibilities, setting up and following schedules, safety, travel and transportation, managing money, and organizing school and work tasks When a person is diagnosed, cultural and environmental aspects are considered as cultural differences influence aspects of daily life such as communication and organization. Demographics: It is estimated that about 200 million people worldwide have an intellectual disability. Source: Special Olympics Reading and Dyslexia Definition: Dyslexia is a learning disability that affects a person’s ability to read. These individuals typically read at levels significantly lower than expected despite having normal intelligence. Although the disorder varies from person to person, common characteristics among people with dyslexia are difficulty with phonological processing (the manipulation of sounds), spelling, and / or rapid visual verbal responding. Adult-onset dyslexia usually occurs because of brain injury or in the context of dementia; this contrasts with people with dyslexia who were never diagnosed as children or adolescents. Dyslexia can be inherited in some families; recent studies have identified a number of genes that may predispose an individual to developing dyslexia. Characteristics: Reading disabilities may include an inability to perceive text or to process the meaning of words, phrases, and ideas. The disability may be the result of a congenital difference, injury, delayed development, neurological or physical disability. Some specific reading disabilities have been identified and are recognized by professionals by diagnosis, such as Dyslexia. Often the diagnosis of a learning disability will include components of a reading impairment. Demographics: Dyslexia is thought to be one of the most common language-based learning disabilities. It is the most common cause of reading, writing, and spelling difficulties. Of people with reading difficulties, 70 to 80% are likely to have some form of dyslexia. It is estimated that 5 to 10% of the population has dyslexia but this number can also be as high as 17%. It affects similar numbers of boys and girls. Math and Computation Definition: Math and computational disabilities impact a person’s ability to learn and communicate math. Dyscalculia involves an inability to understand arithmetic and how to calculate. This disability can be complicated by dysgraphia, an inability to draw or copy figures and graphs, and anxiety. Dyscalculia may be present from birth or result from an injury, disease, or aging. Characteristics: According to Understood’s What is Dyscalculia and other sources, common signs of dyscalculia include: Trouble grasping the meaning of quantities or concepts like biggest vs smallest Understanding that “5” is the same as “five”, and that they both mean five (5) items Remembering math facts like times tables Counting money or making change Estimating time Judging speed or distance Understanding the logic behind math or holding numbers in their head while solving problems. 22 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Demographics: An estimated 3 to 6% of people have dyscalculia. Attention Deficit Hyperactivity Disorder The DSM-V diagnostics criteria for ADHD is made up of two groups of symptoms: inattention / distraction and hyperactive / impulsive. Children diagnosed with ADHD must display 6 or more inattention/distraction symptoms and / or 6 or more hyperactivity / impulsivity symptoms. Adults diagnosed with ADHD must display 5 or more symptoms in either category. The inattention/distraction criteria include: Diminished attention span Getting distracted by stimuli from the surroundings Difficulty starting, organizing and finishing tasks such as homework Being forgetful, such as forgetting daily activities or losing / misplacing items The hyperactive / impulsive criteria include: Being restless and having difficulties controlling that sensation Having difficulty remaining seated Fidgeting Having difficulty waiting in turn Overly talkative, interrupting conversations (Adapted from NHS, CDC, AAFP national research network) Not all persons with ADHD have symptoms in both categories. The UK National Health Service (NHS) reports that it is estimated that 2 to 3 people out of 10 with ADHD have challenges concerning attention and concentration but not with impulsiveness or hyperactivity. ADHD can also be present together with autism. Most people with ADHD are diagnosed as children. Even though many learn to adapt, according to the NHS, adults with ADHD can have challenges with things like work performance or managing relationships. Demographics: Prevalence among children is estimated between 2 and 7% globally, and around 4% in adults. Autism Spectrum Disorders The World Health Organisation defines autism spectrum disorders (ASD) as a group of complex brain development disorders. They cover a large range of conditions with common characteristics including difficulties in social interaction and communication and a restricted and repetitive repertoire of interests and activities. Asperger Syndrome is no longer a separate diagnosis but is classified as a form of autism spectrum disorder. There are two main criteria for diagnosing autism spectrum disorders in the DSM-V: 1. Restrictions in social communication and social interaction. The deficits must be present in different contexts, such as at home as well as in school or at work. This could present as difficulty engaging in conversations or making friends. 2. Repetitive behaviours such as following strict routines or making repetitive movements. 23 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict To make an autism diagnosis, the symptoms must have significant consequences for functioning in social settings, work or school and have occurred during the developmental period (present since childhood) and not be better explained by other conditions. Autism can be present with and without intellectual disability. The diagnostic contains 3 levels of severity depending on the degree of deficits in social interaction (especially relating to language and expression), and level of restricted and repetitive behaviours. According to Autism Europe, Autism is a spectrum, and the degree and manifestation of symptoms varies widely across individuals. While some persons with autism may also have intellectual disabilities, others are of average to high intelligence and lead highly independent lives. Characteristics: Sensory issues such as sensitivity to sound, smell, light Difficulties with verbal and non-verbal communication. It may be difficult to understand or use facial expressions, gestures and language. People with autism often find it hard to understand non-literal expressions. Challenges in social interactions such as recognizing other peoples’ emotions and intentions and expressing their own emotions. People with autism may feel overwhelmed in social situations. Demographics: According to epidemiological studies, approximately 1 in 100 people are affected by autism. (Source: Autism Europe). Non-Verbal Learning Disability Definition: Nonverbal Learning Disability (NLD) is very much like Asperger Syndrome (AS), in which people with the syndrome have normal intelligence and language development but have trouble with social skills, sensory input, and making transitions. AS and NLD are generally thought to describe the same kind of disorder but differ in severity, with AS describing more severe symptoms. Characteristics: According to the University of Michigan, Michigan Medicine, some of the signs of NLD include: Great vocabulary and verbal expression Excellent memory skills Attention to detail, but missing the big picture Poor abstract reasoning Concrete thinking Physical awkwardness, poor coordination Poor social skills Trouble adjusting to changes Anxiety, depression, low self-esteem Demographics: Studies estimate that around 1 in 100, or 1%, of children in the United States may have NLD. It tends to affect boys and girls about equally. Barriers for People with Cognitive Disabilities From the European Commission pilot project study on inclusive web accessibility for persons with cognitive disabilities: 24 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict In the context of web accessibility, challenges include: Finding important information Filling out forms Managing passwords Understanding information Understanding and using controls Keeping focused Information overload, caused by cluttered design or too many text elements Time-outs that cause stress and make it difficult to plan People without cognitive disabilities also experience these barriers to a lesser degree. A website with complicated forms and distracting elements is hard to understand and fill out for anyone. Where a person without cognitive disabilities may take more time to finish the task, a person with cognitive disabilities may give up. User tests conducted in a research project on requirements for cognitive accessibility show that people with and without cognitive disabilities both benefit from features that make websites easier to understand and use. Solutions for People with Cognitive Disabilities Accessibility – General Allow adequate time to prepare for tasks and take in new information In communications: check for understanding and give feedback Minimize background noises to support concentration e.g. while completing a task or communicating Provide structure and clear instructions in education and work environments Use plain language or easy-to-read Accessibility – Physical Environment Key rooms or spaces are designed to be easy to find Design of accessible routes is simple and intuitive Signage should be large and clear, easy to understand and in plain language Wayfinding should be simple with tactile, graphic, audible or architectural cues that are easy to follow. Accessibility in ICT Environments Simplified content Simplified distraction-free interfaces Provide information through different means – text, audio, images Allow adequate time to complete tasks Highlight information that is most important for the user Enable personalized settings (e.g. for layout, time management, content) Assistive Technologies Assistive technology and adaptive strategies for cognitive disabilities are designed to support the use of mental functions. The technologies and strategies are not specific to certain conditions, they assist with specific tasks. 25 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict The following list provides a non-extensive overview of assistive technologies and adaptive strategies that support mental functions. Attention and focusing o Computer-based prompting applications to assist with staying on task o Productivity apps for organizing tasks o To-do lists o Time management apps o Task management apps for breaking down tasks into steps Memory o Audio prompting devices to assist with memory o Auto-complete for web-based forms o Password managers o Audio note-takers and reminders o Apps/technology providing cues for actions Perceptual functions o Direction-finding applications Emotional functions o Apps for mindfulness and to reduce stress o Apps for anxiety management and coping strategies Reading and writing o Audio books and reading software o Speech synthesizers / screen readers o Word prediction / lookup o Visual / audio alternatives to text in signage, messages, instructions o Speech-recognition software Communication o Augmentative and alternative communication (AAC) devices o Synchronized speech and highlighting o Computerized voice output communication aids o Computer-assisted instruction for word recognition, math, spelling, and social skills to be used in education Resources on Cognitive Disabilities AAFP national research network: ADHD assessment table (PDF) ADHD Europe: ADHD Myths and Facts ADHD UK: ADHD Incidence American Psychiatric Association: What is intellectual disability? American Association on Intellectual and Developmental Disabilities: Defining Criteria for Intellectual Disability Autism Europe: Prevalence Rate of Autism Autism Europe: About autism European Commission: Study on Inclusive Web Accessibility for Persons with Cognitive Disabilities (PDF) European Dyslexia Association: What is dyslexia National Institute for Learning Development Canada: Learning Disabilities National Institute of Neurological Disorders and Stroke: Dyslexia 26 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict National Resource Center on ADHD: About ADHD (PDF) UK National Health Service: ADHD diagnosis UK National Health Service: Overview: Learning disabilities Understood: What is Dyscalculia? US Centers for Disease Control and Prevention: Signs and Symptoms of Autism Spectrum Disorder World Health Organisation: International Classification of Functioning, Disability and Health. World Health Organization, Fact Sheet: Autism World Health Organization: Neurological Disorders Public Health Challenges (PDF) 7. Seizure Disabilities Overview Seizure disabilities occur when a seizure disorder interferes with a person’s regular activities. Seizures can range from mild to severe, including loss of consciousness. General Seizure Disorders Definition: According to the Mayo Clinic: A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in behavior, movements, or feelings, and in levels of consciousness. If a person has two or more seizures or a tendency to have recurrent seizures, they have epilepsy. Characteristics: According to the Merck Manual, depending on the type, a seizure can include a variety of symptoms ranging from visual hallucinations and an inability to speak to convulsions and falling down. Demographics: According to the WHO, 50 million people have epilepsy globally, which means that it is one of the most common neurological diseases. Photosensitive Epilepsy Definition: According to Epilepsy Action: Photosensitive epilepsy is a condition in which people have seizures triggered by flashing or flickering lights or patterns. There are 2 groups of people who have photosensitive epilepsy: people who only have seizures triggered by flashing or flickering lights, or patterns (sometimes called pure photosensitivity), and people who have seizures triggered by flashing or flickering lights or patterns but also have seizures at other times. Characteristics: According to Epilepsy Action: Different people will be affected by different flash or flicker rates. Lights that flash or flicker between 16 and 25 times per second are most likely to trigger seizures but some people are sensitive to rates as low as 3 or as high as 60 per second. Different people may be affected by different patterns. Those patterns with a high contrast or some that move are more likely to trigger seizures. Some video games often contain potentially provocative light stimulation. Demographics: Approximately 3% of people with epilepsy have photosensitive epilepsy. Barriers for People with Seizure Disorders From the W3C’s Web Accessibility Initiative and other sources: 27 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Activities in which a sudden loss of consciousness could cause serious harm, such as swimming, taking a bath, or using power tools. Moving, blinking, or flickering content in videos, films, websites, and other technologies. Web browsers and media players that do not provide controls to stop or turn off video or animations Solutions for People with Seizure Disorders Accessibility Web pages that do not contain anything that flashes more than three times in any one second period, or the flash is below the general flash and red flash thresholds. Assistive Technologies Mobile digital diary apps with reminders Smart watches that detect seizures and send alerts or provide GPS location Service animals Wearables with an alert button to call for help Supportive gear and protective wear in case of a fall Flicker-free monitors Monitor glare guards Non-glare glasses Resources on Seizure Disabilities Epilepsy Action Australia: Epilepsy Products Epilepsy Foundation: Epilepsy for Parents and Caregivers Mayo Clinic: Diseases and Conditions: Seizures Merck Sharp & Dohme: Seizure Disorders British Epilepsy Association Epilepsy Action: Photosensitivity Epilepsy World Health Organisation: Fact sheet on epilepsy 8. Psychological Disabilities Overview There are different types of psychological disabilities or mental ill-health which affect a person’s perceptions, thoughts, feelings, mood and behavior. These conditions can be occasional or long-lasting. Psychological disabilities include: Anxiety disorders, including panic disorders, phobias Mood disorders, including depression and bipolar disorder Psychotic disorders, including schizophrenia Anxiety Disorders Definition: According to the US National Institute of Mental Health: Occasional anxiety is a normal part of life. Many people worry about things like health, money, or family problems but anxiety disorders involve more than temporary worry or fear. For people with an anxiety disorder, the anxiety does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, schoolwork, and relationships. There are several types of anxiety disorders, including generalized anxiety disorder, panic disorder, social anxiety disorder, and various phobia-related disorders. 28 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict Demographics: The prevalence of anxiety disorders across the world varies from 2.5 to 7% by country. In 2017, an estimated 284 million people experienced an anxiety disorder, making it the most prevalent mental health disorder. Generalized Anxiety Disorder (GAD) Definition: Generalized anxiety disorder (GAD) usually involves a persistent feeling of anxiety or dread which can interfere with daily life. It is not the same as occasionally worrying about things or experiencing anxiety due to stressful life events. People living with GAD experience frequent anxiety for months, if not years. Characteristics: According to the US National Institute of Mental Health: Feeling restless, wound-up or on-edge Difficulty concentrating Being easily fatigued Having sleep problems Having headaches, muscle aches, stomachaches, or unexplained pains Panic Disorder Definition: People with panic disorder have frequent and unexpected panic attacks. Panic attacks are sudden periods of intense fear, discomfort, or sense of losing control even when there is no clear danger or trigger. Not everyone who experiences a panic attack will develop panic disorder. Characteristics: During a panic attack, a person may experience: Pounding or racing heart Sweating Trembling or tingling Chest pain Feelings of impending doom Feelings of being out of control Social Anxiety Disorder Definition: Social anxiety disorder is an intense, persistent fear of being watched and judged by others. For people with social anxiety disorder, the fear of social situations may feel so intense that it seems beyond their control. For some people, this fear may get in the way of going to work, attending school, or doing everyday things. Characteristics: Feeling very self-conscious, embarrassed, and awkward in front of other people. Blushing, sweating, trembling, rapid heart rate, or feeling like their mind is blank. Feeling nauseous. A rigid body posture, little eye contact, or speaking with an overly soft voice. Mood Disorders Mood disorders affect a person’s emotional state. Emotions may fluctuate between extreme sadness and extreme happiness or there may be prolonged periods of sadness and loss of interest in activities that were previously enjoyable. 29 Certified Professional in Accessibility Core Competencies Body of Knowledge 2023 International Association of Accessibility Professionals, A division of G3ict According to the US Government Mental Health Service, the most common mood disorders are depression, bipolar disorder, seasonal affective disorder, and self-harm. Bipolar Disorder Definition: According to the UK National Health Service, bipolar disorder is a mental health condition characterized by extreme mood swings. A person may experience episodes of depression and low energy and episodes of mania where they feel high and overactive. In contrast to ordinary mood swings, each episode of extreme mood may last for weeks. Characteristics: Symptoms of depression may include: Lacking energy Feeling sad, hopeless, or irritable Difficulty concentrating and remembering things Difficulty sleeping Symptoms of mania may include: Feeling full of energy, with great new ideas and important plans Feeling very happy or overjoyed Being easily distracted or agitated Making decisions or saying things that are out of character and that others see as being risky or harmful Both types of episodes may involve delusions, hallucinations and disturbed or illogical thinking. Demographics: According to the WHO, 19 million people experienced bipolar disorder in 2019 worldwide. Psychotic Disorders Definition: According to the US National Library of Medicine, psychotic disorders are mental disorders that affect a person’s thinking and perceptions. In psychosis, people lose touch with reality. One type of psychotic disorder is schizophrenia. Psychotic symptoms can also occur in other mental disorders such as bipolar disorder or as a result of other issues such as stroke, brain tumors or alcohol or drug addiction. Characteristics: According to the same source, two of the main symptoms of psychosis are delusions and hallucinations. Delusions involve believing things that are not true, like someone following you or the TV sending secret messages. Hallucinations involve perceiving (hearing, seeing or feeling) things that are not there. Persons with schizophrenia may also have other symptoms of cognitive impairments, such as trouble using information, making decisions, and paying attention. Demographics: According to the WHO, schizophrenia affects approximately 24 million people or

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